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  1 / 2084 MEDLINE  
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[PMID]:29362794
[Au] Autor:Friedman DJ; Piccini JP; Wang T; Zheng J; Malaisrie SC; Holmes DR; Suri RM; Mack MJ; Badhwar V; Jacobs JP; Gaca JG; Chow SC; Peterson ED; Brennan JM
[Ad] Endereço:Duke Clinical Research Institute, Durham, North Carolina.
[Ti] Título:Association Between Left Atrial Appendage Occlusion and Readmission for Thromboembolism Among Patients With Atrial Fibrillation Undergoing Concomitant Cardiac Surgery.
[So] Source:JAMA;319(4):365-374, 2018 01 23.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: The left atrial appendage is a key site of thrombus formation in atrial fibrillation (AF) and can be occluded or removed at the time of cardiac surgery. There is limited evidence regarding the effectiveness of surgical left atrial appendage occlusion (S-LAAO) for reducing the risk of thromboembolism. Objective: To evaluate the association of S-LAAO vs no receipt of S-LAAO with the risk of thromboembolism among older patients undergoing cardiac surgery. Design, Setting, and Participants: Retrospective cohort study of a nationally representative Medicare-linked cohort from the Society of Thoracic Surgeons Adult Cardiac Surgery Database (2011-2012). Patients aged 65 years and older with AF undergoing cardiac surgery (coronary artery bypass grafting [CABG], mitral valve surgery with or without CABG, or aortic valve surgery with or without CABG) with and without concomitant S-LAAO were followed up until December 31, 2014. Exposures: S-LAAO vs no S-LAAO. Main Outcomes and Measures: The primary outcome was readmission for thromboembolism (stroke, transient ischemic attack, or systemic embolism) at up to 3 years of follow-up, as defined by Medicare claims data. Secondary end points included hemorrhagic stroke, all-cause mortality, and a composite end point (thromboembolism, hemorrhagic stroke, or all-cause mortality). Results: Among 10 524 patients undergoing surgery (median age, 76 years; 39% female; median CHA2DS2-VASc score, 4), 3892 (37%) underwent S-LAAO. Overall, at a mean follow-up of 2.6 years, thromboembolism occurred in 5.4%, hemorrhagic stroke in 0.9%, all-cause mortality in 21.5%, and the composite end point in 25.7%. S-LAAO, compared with no S-LAAO, was associated with lower unadjusted rates of thromboembolism (4.2% vs 6.2%), all-cause mortality (17.3% vs 23.9%), and the composite end point (20.5% vs 28.7%) but no significant difference in rates of hemorrhagic stroke (0.9% vs 0.9%). After inverse probability-weighted adjustment, S-LAAO was associated with a significantly lower rate of thromboembolism (subdistribution hazard ratio [HR], 0.67; 95% CI, 0.56-0.81; P < .001), all-cause mortality (HR, 0.88; 95% CI, 0.79-0.97; P = .001), and the composite end point (HR, 0.83; 95% CI, 0.76-0.91; P < .001) but not hemorrhagic stroke (subdistribution HR, 0.84; 95% CI, 0.53-1.32; P = .44). S-LAAO, compared with no S-LAAO, was associated with a lower risk of thromboembolism among patients discharged without anticoagulation (unadjusted rate, 4.2% vs 6.0%; adjusted subdistribution HR, 0.26; 95% CI, 0.17-0.40; P < .001), but not among patients discharged with anticoagulation (unadjusted rate, 4.1% vs 6.3%; adjusted subdistribution HR, 0.88; 95% CI, 0.56-1.39; P = .59). Conclusions and Relevance: Among older patients with AF undergoing concomitant cardiac surgery, S-LAAO, compared with no S-LAAO, was associated with a lower risk of readmission for thromboembolism over 3 years. These findings support the use of S-LAAO, but randomized trials are necessary to provide definitive evidence.
[Mh] Termos MeSH primário: Apêndice Atrial/cirurgia
Fibrilação Atrial
Procedimentos Cirúrgicos Cardíacos/efeitos adversos
Readmissão do Paciente/estatística & dados numéricos
Tromboembolia/prevenção & controle
[Mh] Termos MeSH secundário: Idoso
Valva Aórtica/cirurgia
Ponte de Artéria Coronária/efeitos adversos
Seguimentos
Seres Humanos
Estimativa de Kaplan-Meier
Valva Mitral/cirurgia
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Dispositivo para Oclusão Septal
Tromboembolia/epidemiologia
Tromboembolia/etiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.20125


  2 / 2084 MEDLINE  
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[PMID]:28453794
[Au] Autor:Kawahito K; Kimura N; Komiya K; Nakamura M; Misawa Y
[Ad] Endereço:Division of Cardiovascular Surgery, Jichi Medical University, Tochigi, Japan.
[Ti] Título:Blood flow competition after aortic valve bypass: an evaluation using computational fluid dynamics.
[So] Source:Interact Cardiovasc Thorac Surg;24(5):670-676, 2017 05 01.
[Is] ISSN:1569-9285
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Aortic valve bypass (AVB) (apico-aortic conduit) remains an effective surgical alternative for patients in whom surgical aortic valve replacement or transcatheter aortic valve implantation is not feasible. However, specific complications include thrombus formation, possibly caused by stagnation arising from flow competition between the antegrade and retrograde flow, but this has not been fully investigated. The aim of this study was to analyse flow characteristics after AVB and to elucidate mechanisms of intra-aortic thrombus using computational fluid dynamics (CFD). METHODS: Flow simulation was performed on data obtained from a 73-year-old postoperative AVB patient. Three-dimensional cine phase-contrast magnetic resonance imaging at 3 Tesla was used to acquire flow data and to set up the simulation. The vascular geometry was reconstructed using computed tomography angiograms. Flow simulations were implemented at various ratios of the flow rate between the ascending aorta and the graft. Results were visualized by streamline and particle tracing. RESULTS: CFD demonstrated stagnation in the ascending aorta-arch when retrograde flow was dominant, indicating that the risk of thrombus formation exists in the ascending arch in cases with severe aortic stenosis and/or poor left ventricular function. Meanwhile, stagnation was observed in the proximal descending aorta when the antegrade and retrograde flow were equivalent, suggesting that the descending aorta is critical when aortic stenosis is not severe. CONCLUSIONS: Flow stagnation in the aorta which may cause thrombus was observed when retrograde flow was dominant and antegrade/retrograde flows were equivalent. Our results suggest that anticoagulants might be recommended even in patients who receive biological valves.
[Mh] Termos MeSH primário: Aorta Torácica/cirurgia
Estenose da Valva Aórtica/cirurgia
Valva Aórtica/cirurgia
Apêndice Atrial/cirurgia
Velocidade do Fluxo Sanguíneo/fisiologia
Simulação por Computador
Imagem Cinética por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Idoso
Anastomose Cirúrgica/métodos
Aorta Torácica/diagnóstico por imagem
Aorta Torácica/fisiopatologia
Valva Aórtica/diagnóstico por imagem
Valva Aórtica/fisiopatologia
Estenose da Valva Aórtica/fisiopatologia
Apêndice Atrial/diagnóstico por imagem
Apêndice Atrial/fisiopatologia
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/icvts/ivw428


  3 / 2084 MEDLINE  
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[PMID]:29480827
[Au] Autor:Wang B; Li H; Zhang L; He L; Zhang J; Liu C; Wang J; Lv Q; Shang X; Liu J; Xie M
[Ad] Endereço:Department of Ultrasound.
[Ti] Título:Congenital left atrial appendage aneurysm: A rare case report and literature review.
[So] Source:Medicine (Baltimore);97(2):e9344, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Left atrial appendage aneurysms (LAAA) are rare. Patients with LAAA are often diagnosed incidentally or after cardiac tachyarrhythmia or systemic thromboembolism happen. Early diagnosis and surgical resection is of utmost importance to prevent hazardous adverse events. PATIENT CONCERNS: We present a case of 46-year-old man with congenital LAAA. The individual in this manuscript has given written informed consent to publish these case details. DIAGNOSES: Imaging studies, such as echocardiography, cardiovascular computed tomography (CT) and magnetic resonance imaging (MRI), demonstrated the large cavity arising from the left atrial appendage. The diagnosis of LAAA was confirmed. INTERVENTIONS: The patient underwent an aneurysmectomy without any complications. OUTCOMES: TTE confirmed the disappearance of the LAAA from the left parasternal short-axis view of the aortic root postoperatively. The patient remained asymptomatic without any adverse events at his 3-month follow-up visits. LESSONS: The associated high risk of life-threatening complications and the relative ease of surgical removal suggest that prompt evaluation should be considered in patients with lesions adjacent to the left heart border.
[Mh] Termos MeSH primário: Apêndice Atrial
Aneurisma Cardíaco/congênito
[Mh] Termos MeSH secundário: Apêndice Atrial/diagnóstico por imagem
Apêndice Atrial/patologia
Apêndice Atrial/cirurgia
Aneurisma Cardíaco/diagnóstico por imagem
Aneurisma Cardíaco/patologia
Aneurisma Cardíaco/cirurgia
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009344


  4 / 2084 MEDLINE  
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[PMID]:28459917
[Au] Autor:McCauley BD; Chu AF
[Ad] Endereço:Internal Medicine Resident, Rhode Island Hospital, The Warren Alpert Medical School of Brown University.
[Ti] Título:Minimally Invasive Closure of the Left Atrial Appendage: A Non-Pharmacologic Approach to Prevention of Stroke in Patients with Atrial Fibrillation.
[So] Source:R I Med J (2013);100(5):23-26, 2017 May 01.
[Is] ISSN:2327-2228
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Atrial Fibrillation's (AF) role in the pathogenesis of thromboembolic stroke has been well established, with estimates from trials of approximately 15-20% of all strokes in the U.S. Research shows more than 90% of atrial thrombi originate from the left atrial appendage (LAA). Traditionally, oral anticoagulants (OACs) have been the keystone of management for AF in reducing the risk of thromboembolic stroke. However, OACs also pose a non-negligible risk of bleeding with between 30-50% of eligible patients not receiving OACs due to absolute contraindications or perceived increased bleeding risk. New technologies aimed at isolating the LAA through ligation, exclusion, or occlusion are attempting to mitigate the embolic risk posed by LAA thrombi while simultaneously reducing the bleeding risk associated with OAC. In this review, we discuss the safety, efficacy, and clinical utility of these technologies as alternatives to OACs. [Full article available at http://rimed.org/rimedicaljournal-2017-05.asp].
[Mh] Termos MeSH primário: Apêndice Atrial/cirurgia
Fibrilação Atrial/complicações
Fibrilação Atrial/cirurgia
Acidente Vascular Cerebral/prevenção & controle
[Mh] Termos MeSH secundário: Seres Humanos
Acidente Vascular Cerebral/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


  5 / 2084 MEDLINE  
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[PMID]:29381951
[Au] Autor:Wong CK; Chan PH; Lam CC; Kwok OH; Lam YY; Siu CW
[Ad] Endereço:Cardiology Division, Department of Medicine, The University of Hong Kong.
[Ti] Título:WATCHMAN device-related thrombus successfully treated with apixaban: A case report.
[So] Source:Medicine (Baltimore);96(47):e8693, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Among atrial fibrillation patients with high risk of bleeding, left atrial appendage occlusion has emerged as an alternative to long-term oral anticoagulation therapy for stroke prevention. Device-related thrombus remains a major concern because it may result in recurrent embolic events. To date, there is no consensus on the optimal method of treating device-related-thrombus. PATIENT CONCERNS: A 78-year-old man with atrial fibrillation had an episode of intracranial hemorrhage while taking warfarin. He subsequently underwent percutaneous placement of a 30-mm Watchman device to the left atrial appendage. He was prescribed dual anti-platelet therapy with aspirin and clopidogrel. DIAGNOSIS: Reassessment echocardiography 3 months later found device-related thrombus. INTERVENTIONS: The antithrombotic regimen was switched from dual antiplatelet therapy to apixaban. OUTCOMES: Reassessment echocardiography 3 months later revealed complete resolution of the device-related thrombus. Apixaban was stopped. He had dual antiplatelet therapy for 6 more months followed by life-long aspirin. There was no bleeding complication since implantation of Watchman device. LESSONS: We demonstrated successful treatment of device-related thrombus with a short course of apixaban with complete resolution of thrombus. Further randomized controlled trials are required to determine the choice and duration of drug therapy for device-related thrombus.
[Mh] Termos MeSH primário: Fibrilação Atrial/cirurgia
Inibidores do Fator Xa/uso terapêutico
Próteses e Implantes/efeitos adversos
Pirazóis/uso terapêutico
Piridonas/uso terapêutico
Trombose/tratamento farmacológico
Trombose/etiologia
[Mh] Termos MeSH secundário: Idoso
Anticoagulantes/administração & dosagem
Aspirina/administração & dosagem
Apêndice Atrial/cirurgia
Seres Humanos
Masculino
Trombose/prevenção & controle
Ticlopidina/administração & dosagem
Ticlopidina/análogos & derivados
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants); 0 (Factor Xa Inhibitors); 0 (Pyrazoles); 0 (Pyridones); 3Z9Y7UWC1J (apixaban); A74586SNO7 (clopidogrel); OM90ZUW7M1 (Ticlopidine); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008693


  6 / 2084 MEDLINE  
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[PMID]:28456775
[Au] Autor:Bartus K; Podolec J; Lee RJ; Kapelak B; Sadowski J; Bartus M; Oles K; Ceranowicz P; Trabka R; Litwinowicz R
[Ad] Endereço:Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, Collegium Medicum, John Paul II Hospital, Cracow, Poland.
[Ti] Título:Atrial natriuretic peptide and brain natriuretic peptide changes after epicardial percutaneous left atrial appendage suture ligation using LARIAT device.
[So] Source:J Physiol Pharmacol;68(1):117-123, 2017 Feb.
[Is] ISSN:1899-1505
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:Percutaneous left atrial appendage closure is an alternative treatment for stroke and systemic thromboembolism risk reduction in non-valvular atrial fibrillation (AF). However, the neurohormonal impact of epicardial exclusion of the left atrial appendage (LAA) with the LARIAT procedure is unknown. Evaluation of changes in atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) levels in AF patients underwent percutaneous LAA suture ligation. Sixty six patients underwent successfully percutaneous LAA suture ligation using LARIAT device. The level of ANP and BNP was measured before and 3 months after procedure. Mean ANP level before procedure was 249 ± 77 pg/mL (range from 95 pg/mL to 503 pg/mL) and mean BNP level was 481 ± 517 pg/mL (range from 34 pg/mL to 2508 pg/mL). Three months after procedure mean ANP level was 249 ± 79 pg/mL (range from 98 pg/mL to 492 pg/mL) and mean BNP level was 495 ± 526 pg/mL (range from 52 pg/mL to 2420 pg/mL). At 3 months follow up after percutaneous LAA suture ligation there were no significant differences in ANP and BNP levels.
[Mh] Termos MeSH primário: Apêndice Atrial/cirurgia
Fibrilação Atrial/cirurgia
Fator Natriurético Atrial/sangue
Ligadura/instrumentação
Peptídeo Natriurético Encefálico/sangue
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Fibrilação Atrial/sangue
Feminino
Seres Humanos
Masculino
Meia-Idade
Suturas
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
114471-18-0 (Natriuretic Peptide, Brain); 85637-73-6 (Atrial Natriuretic Factor)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


  7 / 2084 MEDLINE  
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[PMID]:29362774
[Au] Autor:Ferraris VA
[Ad] Endereço:Departmentof Surgery, University of Kentucky, Lexington.
[Ti] Título:Left Atrial Appendage Occlusion During Cardiac Operations for Prevention of Thromboembolic Events.
[So] Source:JAMA;319(4):345-347, 2018 01 23.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Apêndice Atrial/cirurgia
Tromboembolia/prevenção & controle
[Mh] Termos MeSH secundário: Fibrilação Atrial/cirurgia
Procedimentos Cirúrgicos Cardíacos
Seres Humanos
Acidente Vascular Cerebral/prevenção & controle
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.20361


  8 / 2084 MEDLINE  
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[PMID]:27771552
[Au] Autor:Enomoto Y; Gadiyaram VK; Gianni C; Horton RP; Trivedi C; Mohanty S; Di Biase L; Al-Ahmad A; Burkhardt JD; Narula A; Janczyk G; Price MJ; Afzal MR; Atoui M; Earnest M; Swarup V; Doshi SK; van der Zee S; Fisher R; Lakkireddy DR; Gibson DN; Natale A; Reddy VY
[Ad] Endereço:Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, New York, New York.
[Ti] Título:Use of non-warfarin oral anticoagulants instead of warfarin during left atrial appendage closure with the Watchman device.
[So] Source:Heart Rhythm;14(1):19-24, 2017 01.
[Is] ISSN:1556-3871
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In the stroke prevention trials of left atrial appendage closure with the Watchman device (Boston Scientific), a postimplantation antithrombotic regimen of 6 weeks of warfarin was used. OBJECTIVE: Given the clinical complexity of warfarin use, the purpose of this study was to study the relative feasibility and safety of using non-warfarin oral anticoagulants (NOACs) instead of warfarin during the peri- and initial postimplantation periods after Watchman implantation. METHODS: This was a retrospective multicenter study of consecutive patients undergoing Watchman implantation and receiving peri- and postprocedural NOACs or warfarin. Transesophageal echocardiography or chest computed tomography was performed between 6 weeks and 4 months postimplant to assess for device-related thrombosis. Bleeding and thromboembolic events also were evaluated at the time of follow-up. RESULTS: In 5 centers, 214 patients received NOACs (46% apixaban, 46% rivaroxaban, 7% dabigatran, and 1% edoxaban) in either an uninterrupted (82%) or a single-held-dose (16%) fashion. Compared to a control group receiving uninterrupted warfarin (n = 212), the rates of periprocedural complications, including bleeding events, were similar (2.8% vs 2.4%, P = 1). At follow-up, the rates of device-related thrombosis (0.9% vs 0.5%, P = 1), composite of thromboembolism or device-related thrombosis (1.4% vs 0.9%, P = 1), and postprocedure bleeding events (0.5% vs 0.9%, P = .6) also were comparable between the NOAC and warfarin groups. CONCLUSION: NOACs proved to be a feasible peri- and postprocedural alternative regimen to warfarin for preventing device-related thrombosis and thromboembolic complications expected early after appendage closure with the Watchman device, without increasing the risk of bleeding.
[Mh] Termos MeSH primário: Anticoagulantes/administração & dosagem
Apêndice Atrial/diagnóstico por imagem
Apêndice Atrial/cirurgia
Implante de Prótese/efeitos adversos
Tromboembolia/prevenção & controle
[Mh] Termos MeSH secundário: Administração Oral
Idoso
Idoso de 80 Anos ou mais
Anticoagulantes/farmacologia
Apêndice Atrial/efeitos dos fármacos
Fibrilação Atrial/prevenção & controle
Estudos de Coortes
Ecocardiografia Transesofagiana/métodos
Feminino
Seguimentos
Seres Humanos
Masculino
Próteses e Implantes
Implante de Prótese/métodos
Estudos Retrospectivos
Medição de Risco
Tromboembolia/etiologia
Resultado do Tratamento
Varfarina/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anticoagulants); 5Q7ZVV76EI (Warfarin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180121
[Lr] Data última revisão:
180121
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161107
[St] Status:MEDLINE


  9 / 2084 MEDLINE  
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[PMID]:28930824
[Au] Autor:Song H; Zhou Q; Zhang L; Deng Q; Wang Y; Hu B; Tan T; Chen J; Pan Y; He F
[Ad] Endereço:aDepartment of Ultrasound Imaging, Renmin Hospital of Wuhan University bComputer Science and Technology School, Wuhan University, Wuhan, China.
[Ti] Título:Evaluating the morphology of the left atrial appendage by a transesophageal echocardiographic 3-dimensional printed model.
[So] Source:Medicine (Baltimore);96(38):e7865, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The novel 3-dimensional printing (3DP) technique has shown its ability to assist personalized cardiac intervention therapy. This study aimed to determine the feasibility of 3D-printed left atrial appendage (LAA) models based on 3D transesophageal echocardiography (3D TEE) data and their application value in treating LAA occlusions.Eighteen patients with transcatheter LAA occlusion, and preprocedure 3D TEE and cardiac computed tomography were enrolled. 3D TEE volumetric data of the LAA were acquired and postprocessed for 3DP. Two types of 3D models of the LAA (ie, hard chamber model and flexible wall model) were printed by a 3D printer. The morphological classification and lobe identification of the LAA were assessed by the 3D chamber model, and LAA dimensions were measured via the 3D wall model. Additionally, a simulation operative rehearsal was performed on the 3D models in cases of challenging LAA morphology for the purpose of understanding the interactions between the device and the model.Three-dimensional TEE volumetric data of the LAA were successfully reprocessed and printed as 3D LAA chamber models and 3D LAA wall models in all patients. The consistency of the morphological classifications of the LAA based on 3D models and cardiac computed tomography was 0.92 (P < .01). The differences between the LAA ostium dimensions and depth measured using the 3D models were not significant from those measured on 3D TEE (P > .05). A simulation occlusion was successfully performed on the 3D model of the 2 challenging cases and compared with the real procedure.The echocardiographic 3DP technique is feasible and accurate in reflecting the spatial morphology of the LAA, which may be promising for the personalized planning of transcatheter LAA occlusion.
[Mh] Termos MeSH primário: Apêndice Atrial/diagnóstico por imagem
Ecocardiografia Tridimensional/métodos
Ecocardiografia Transesofagiana/métodos
Modelos Anatômicos
Impressão Tridimensional
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Apêndice Atrial/patologia
Fibrilação Atrial/diagnóstico por imagem
Fibrilação Atrial/patologia
Fibrilação Atrial/cirurgia
Cateterismo Cardíaco/instrumentação
Angiografia por Tomografia Computadorizada/métodos
Estudos de Viabilidade
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171015
[Lr] Data última revisão:
171015
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170921
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007865


  10 / 2084 MEDLINE  
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[PMID]:28917494
[Au] Autor:Sanhoury M; Fassini G; Dello Russo A; Lumia G; Bartorelli A
[Ad] Endereço:Centro Cardiologico Monzino, IRCCS, Milan, Italy. Electronic address: drsanhory@yahoo.com.
[Ti] Título:Early Dislodgment and Migration of a Left Atrial Appendage Closure Device.
[So] Source:Am J Cardiol;120(10):1905-1907, 2017 Nov 15.
[Is] ISSN:1879-1913
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A 68-year-old man underwent pulmonary vein isolation with cryoballoon combined with left atrial appendage closure using a LAmbre device. The device was dislodged and embolized early after implantation with no symptoms, and it was retrieved percutaneously. An early in-hospital check of the device position after implantation is important for early recognition of any possible device-related complication.
[Mh] Termos MeSH primário: Apêndice Atrial/diagnóstico por imagem
Migração de Corpo Estranho/etiologia
Comunicação Interatrial/cirurgia
Complicações Pós-Operatórias/diagnóstico
Dispositivo para Oclusão Septal/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Apêndice Atrial/cirurgia
Remoção de Dispositivo
Ecocardiografia
Migração de Corpo Estranho/diagnóstico
Migração de Corpo Estranho/cirurgia
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170918
[St] Status:MEDLINE



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